1. Administration of high titer convalescent anti-SARS-CoV-2 plasma: From donor selection to monitoring recipient outcomes
- Author
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Michael Augenbraun, Harsha Bajaj, David Daniel, Bo Lin, Purvi Patel, William Fyke, Jenny Libien, Robert Colbourn, Dominick Giovaniello, Steven H. Kang, D Emechebe, Absia Jabbar, Maxine Easy, Mouyed Alawad, Allen J. Norin, Elmer Gabutan, Amir Dehghani, Ballabh Das, Dimitar B. Nikolov, Rachelle Mendoza, Luis Tatem, Kenneth Bromberg, Prem Premsrirut, and Ana Vasileva
- Subjects
Male ,0301 basic medicine ,Blood Donors ,Antibodies, Viral ,Plasma ,0302 clinical medicine ,COVID-19, coronavirus disease of 2019 ,SUNY, State University of New York ,Immunology and Allergy ,biology ,ELISA, enzyme-linked immunosorbent assay ,General Medicine ,Middle Aged ,HIV, human immunodeficiency virus ,Titer ,ELISA ,Female ,LFA, lateral flow assay ,Convalescent plasma donation and treatment ,Antibody ,Research Article ,AABB, American Association of Blood Banks ,Adult ,CP, convalescent plasma ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Immunology ,IgG, immunoglobulin G ,SARS-CoV-2, severe acute respiratory syndrome coronavirus 2 ,H1N1, influenza A virus subtype H1N1 ,Donor Selection ,H5N1, highly pathogenic Asian avian influenza A subtype H5N1 ,RBD, receptor binding domain ,03 medical and health sciences ,NYBC, New York Blood Center ,UHB, University Hospital of Brooklyn ,Internal medicine ,medicine ,Humans ,SARS, severe acute respiratory syndrome ,High titer ,Adverse effect ,IQR, interquartile range ,COVID-19 Serotherapy ,Aged ,Retrospective Studies ,RT PCR, reverse transcriptase polymerase chain reaction ,SARS-CoV-2 ,business.industry ,Donor selection ,MERS, Middle East respiratory syndrome ,Lateral flow antibody assay ,Immunization, Passive ,COVID-19 ,Retrospective cohort study ,HR, hazard ratio ,CI, confidence interval ,IgM, immunoglobulin M ,030104 developmental biology ,ICU patients ,Immunoglobulin M ,Immunoglobulin G ,RNA, ribonucleic acid ,biology.protein ,business ,030215 immunology - Abstract
Early in the SARS-CoV-2 pandemic, convalescent plasma (CP) therapy was proposed as a treatment for severely ill patients. We conducted a CP treatment protocol under the Mayo Clinic Extended Access Program at University Hospital Brooklyn (UHB). Potential donors were screened with a lateral flow assay (LFA) for IgM and IgG antibodies against the SARS-CoV-2 S1 receptor-binding domain (RBD). Volunteers that were LFA positive were tested with an ELISA to measure IgG titers against the RBD. Subjects with titers of at least 1:1024 were selected to donate. Most donors with positive LFA had acceptable titers and were eligible to donate. Out of 171 volunteers, only 65 tested positive in the LFA (38.0%), and 55 (32.2%) had titers of at least 1:1024. Before our donation program started, 31 CP units were procured from the New York Blood Center (NYBC). Among the 31 CP units that were obtained from the NYBC, 25 units (80.6%) were positive in the LFA but only 12 units (38.7%) had titers of at least 1:1024. CP was administered to 28 hospitalized COVID-19 patients. Patients who received low titer CP, high titer CP and patients who did not receive CP were followed for 45 days after presentation. Severe adverse events were not associated with CP transfusion. Death was a less frequent outcome for patients that received high titer CP (>1:1024) 38.6% mortality, than patients that received low titer CP (≤1:1024) 77.8% mortality.
- Published
- 2021
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